AATBS EXAM 2

Question ID #4518: The ages at which early physical milestones are reached vary from child to child, and the experts often report somewhat different ages. Generally, however, babies take their first steps alone at about: Select one: A. 12 months of age. B. 9 months of age. C. 18 months of age. D. 14 months of age.

The correct answer is A.At the age of 10 to 11 months, babies can typically stand alone and walk with help. Then, at about 12 months, babies usually take their first steps alone. Answer B: While some children can stand and walk alone at 9 months, this is not the norm. Answer C: 18 months would be considered late for standing and walking alone. Answer D: This would be considered a little late for standing and walking alone.

Question ID #4502: Authoritarian parents tend to produce children who: Select one: A. are dependent, passive, and submissive. B. exhibit low levels of self-reliance. C. have low levels of self-control. D. are independent and self-assertive.

The correct answer is A.Baumrind (1972) distinguishes between three parenting styles: authoritarian, authoritative, and permissive. Authoritarian parents impose absolute standards of conduct and stress obedience, and they are willing to use force to obtain compliance. Baumrind found that the children of authoritarian parents often show signs of dependence, passivity, submissiveness, and a limited sense of responsibility. Answer B: Baumrind found that children of permissive parents, who provide their children with few demands and show moderate levels of warmth, exhibit low levels of self-reliance. Answer C: Low levels of self-control are also associated with children of permissive parents. Answer D: Authoritative parents, who combine rational control with warmth, receptivity, and encouragement of independence, produce children who are independent and self-assertive.

Question ID #4495: Generally speaking, the psychological adjustment of children with chronic illness is MOST dependent on which of the following? Select one: A. The child's level of functional impairment B. Peer acceptance C. Family attitudes toward the illness D. The child's personality type

The correct answer is A.If you're unfamiliar with research in this area, the best approach is to select the most general response. A number of studies have linked severity of the illness to adjustment outcomes. Some authors argue that it is not so much illness severity, however, but the level of functional disability. Other factors predictive of good adjustment include higher socioeconomic status, a two-parent family, little visible disfiguration, and healthy parental adjustment. Answer B: While peer acceptance may influence the child's psychological adjustment, this answer is very specific, and you are better off choosing a broad, inclusive answer. Answer C: While family attitudes may influence the child's psychological adjustment, you are better off choosing a broad, inclusive answer. Answer D: While the child's personality type may influence the child's psychological adjustment, you are better off choosing a broad, inclusive answer.

Question ID #4471: As defined in the DSM-5, the primary difference between a manic episode and hypomanic episode is that in the latter: Select one: A. the duration of symptoms is longer. B. the symptoms are characterized by a fluctuating course. C. there is not marked impairment in social or occupational functioning. D. delusions and hallucinations, if present, are fragmentary and less severe.

The correct answer is C.Mania and hypomania both involve an abnormally and persistently elevated, expansive, or irritable mood. However, a manic episode (but not a hypomanic episode) involves impairment in functioning, requires hospitalization to avoid danger to self or others, or includes psychotic symptoms. Answer A: A manic episode lasts at least one week while a hypomanic episode lasts at least four days. However, the best differential between the two is the degree of impairment. Answer B: A fluctuating course does not distinguish mania from hypomania. Answer D: Delusions and hallucinations may be present during a manic episode but not during a hypomanic episode.

Question ID #4430: When working with refugee populations, it can be very useful to use refugee community members for outreach, interpretation, and prevention due to the language and cultural barriers between service providers and the population being targeted. While there are many benefits to using community members in this way, this practice can also present unique challenges. What challenges should the social worker be MOST concerned about? Select one: A. Therapeutic boundaries, interpreter distortion, confidentiality, lack of training, and over-identification with clients B. Confidentiality, communication barriers, ethical practice, stereotyping, and lack of training C. Linguistic differences, confidentiality, power differentials, failure to incorporate indigenous coping strategies, and interpreter distortion D. Lack of training, poor collaboration between providers, stigma, ad hoc interpreters, and fragmentation of services

The correct answer is A.Mental health professionals are often severely hampered by the cultural and linguistic barriers presented by working with refuges. The use of refugee community members to serve as paraprofessionals can help overcome some of these barriers, but it presents unique challenges as well. Often paraprofessionals have minimal training and thus may be unfamiliar with therapeutic boundaries. Because these workers are part of the community, confidentiality can be an issue. Since these workers may have been subject to many of the same stresses, traumas, and other issues as the clients, they may have a tendency to over-identify with clients, leading to distortions and difficulties separating their own feelings from those of the client. The use of community members to serve as paraprofessionals should lead to a decrease in communication barriers and stereotyping. Answer B: This answer does not accurately list the challenges of using paraprofessionals.Answer C: The use of community members to serve as paraprofessionals should lead to a decrease in linguistic differences and should contribute to an increase in incorporation of indigenous coping strategies. Answer A covers more challenges that the social worker must be concerned about. Answer D: This answer does not address the issue of confidentiality, which should be high on the list of concerns of professionals who use community members as ad-hoc interpreters.

Question ID #4434: The client is a divorced mother who recently received an eviction notice from her landlord. She would like to contact a lawyer about this but can't afford to pay for legal services. The client has been arguing with her ex-husband lately because he's been late with the child support payments and she needs the money to fix her car, which broke down a week ago. The client also reports concerns about her son, who has been acting out ever since entering middle school and seems kind of upset all the time. She doesn't know how to help him or why he's upset. After partializing the client's problems, what would the social worker and this client deal with FIRST? Select one: A. The problems that need immediate attention B. The problems that the client is most interested in solving C. The problems for which resources are readily available D. The problems that are easiest to resolve

The correct answer is A.Partialization refers to the method of temporarily considering a client's interconnected problems as separate issues so that planning and doing the work toward resolving them can be more manageable. It can be effective for maximizing a client's ability to participate effectively in the planning process. After a client's problems have been partialized, the social worker and the client will ordinarily deal first with those that need immediate attention (e.g., a lack of housing). Answer B: It's true that the client should have a say in determining the priorities for attention; however, the social worker and the client will ordinarily begin by addressing problems that need immediate attention (this is usually the client's preference as well). Answer C: It can be useful to deal first (or, at least, early) with problems for which resources are more available, because the client will then have concrete evidence of the social worker's willingness and ability to help her. Before this, however, it's usually important to address problems that need immediate attention. Answer D: It can be useful to deal first (or, at least, early) with problems that are more readily resolvable because the client will then have concrete evidence of the social worker's willingness and ability to help her. Before this, however, its usually important to address problems that need immediate attention.

Question ID #4508: Regarding the physical changes that accompany growing older, which is the following is true? Select one: A. Physical activity can help prevent the frailty that may come with old age. B. By age 75, the majority of adults have experienced notable hearing loss. C. Older adults need less sleep than younger adults. D. Diabetes is the most common chronic health condition among adults over age 65

The correct answer is A.Regular physical activity in late adulthood is associated with many benefits, including a lowered risk of coronary heart disease, colon cancer, diabetes, high blood pressure, and osteoporosis; a reduced risk of falling; less anxiety and depression; a greater ability to maintain joint strength and mobility; and better cognitive functioning. In addition, maintaining lean muscle helps to prevent frailty and disability. Answer B: Prior to age 75, the majority of adults do not experience significant hearing loss. Among adults age 75 to 79, however, 50 percent or more have hearing deficits that interfere with daily functioning. The biggest problem is a decreasing ability to perceive high-frequency sounds, which makes it difficult to understand human speech, especially when there is a competing noise. Answer C: Older adults do not require less sleep than younger adults; however, they do have more trouble falling asleep, awaken more often during the night, and experience a shift in the timing of sleep that involves going to bed and waking up earlier. Answer D: The most common chronic health conditions among people over age 65 are hypertension and arthritis, followed by heart disease, sinusitis, and diabetes.

Question ID #4465: During her first session, a female client, age 43, tells the social worker that she needs to work on anxiety and relationship issues. She says she divorced her second husband 11 months ago and has been dating a man she met at church for a month, but she thinks he's going to dump her because of her physical problems. The client has type 2 diabetes, which is well-managed with medication. However, she complains of frequent stomach problems, severe headaches, and back pain, noting that she spends a lot of time researching diseases on the internet to try to figure out what's wrong with her besides diabetes. The client has been evaluated by a physician who told her that other than diabetes, she does not have any medical problems. The client's symptoms are MOST suggestive of which of the following DSM-5 diagnoses?. Select one: A. Somatic symptom disorder B. Factitious disorder C. Illness anxiety disorder D. Psychological factors affecting other medical conditions Feedback

The correct answer is A.The client's symptoms are consistent with somatic symptom disorder, which is included in the DSM-5 with somatic symptom and related disorders. The essential feature of this disorder is the presence of multiple somatic symptoms that cause distress or disruption in ones daily life. Answer B: Factitious disorder is characterized by falsification of physical or psychological symptoms or induction of an illness or injury that is associated with an identified deception. No information given in the question suggests that the client is faking or causing her symptoms. Answer C: Illness anxiety disorder is characterized by excessive worry about being or becoming ill and usually does not include somatic symptoms or includes only symptoms of mild intensity. Answer D: The diagnosis of psychological factors affecting other medical conditions is assigned when a person's psychological problems affect the course of a medical condition or interfere with its treatment. The client's symptoms do not seem to be interfering with her management of her diabetes.

Question ID #4466: A 35-year-old graphic designer is seeking help for his fear of public speaking. Due to a recent promotion, he is now required to make regular pitches to prospective clients. Previously, his work was mostly behind the scenes, and he's afraid that he will blow it when making presentations and look incompetent and silly to his coworkers and clients. The client is considering asking to be demoted so that he won't have to make presentations. He states that public speaking has been a problem for him since high school and that he feels like he's having a panic attack whenever he has to speak in front of a group. The MOST likely DSM-5 diagnosis for this client is: Select one: A. social anxiety disorder. B. panic disorder. C. specific phobia. D. generalized anxiety disorder.

The correct answer is A.The client's symptoms meet the diagnostic criteria for social anxiety disorder (social phobia), which is diagnosed when the individual experiences marked fear or anxiety of fear of scrutiny by others in one or more social situations that is out of proportion to the actual threat posed by the situation. Since the client's symptoms occur only when he speaks in public, the specifier "performance only" would be added to his diagnosis. Answer B: Panic disorder is characterized by sudden, unexpected panic attacks. The client's panicky feelings are clearly linked to a specific stressor (public speaking) and, therefore, are not unexpected. Answer C: Specific phobia is characterized by marked fear or anxiety about a specific object or situation, whereas the fear or anxiety associated with social anxiety disorder is related to a fear of scrutiny by others. Answer D: Generalized anxiety disorder involves excessive anxiety and worry about multiple events or activities, which may or may not include social performance, and is diagnosed when symptoms are not better explained by another mental disorder. In this case, the client's symptoms are better explained by social anxiety disorder since the anxiety and worry associated with social anxiety disorder are necessarily related to a fear of scrutiny (negative evaluation) by others.

Question ID #4461: A social worker is working with a 5-year-old boy who often urinates in his bed at night and in his pants at school. The social worker is considering a diagnosis of enuresis but isn't sure whether the boy's disorder is primary or secondary. What piece of information is needed to differentiate between these two types of enuresis? Select one: A. Whether or not the boy was ever continent B. Whether the symptom is involuntary or intentional C. Whether or not the symptomatic behavior can be attributed to the physiological effects of a substance or another medical condition D. Whether or not there are precipitating factors for his condition

The correct answer is A.The essential feature of enuresis is repeated voiding of urine into one's bed or clothes, whether involuntary or intentional, and a chronological age of at least 5 years (or an equivalent developmental level). In early versions of the DSM, the elimination disorders (enuresis and encopresis) were coded as either primary or secondary. The DSM-5 doesn't make this distinction for diagnostic purposes, but it does include this distinction when discussing the development and course of the disorder: enuresis is considered primary if it has not been preceded by a period of urinary continence (the ability to control elimination), and secondary if it has been preceded by a period of urinary continence. Answer B: The DSM-5 does not mention voluntary and involuntary voiding of urine in its definition of enuresis. Answer C: For a diagnosis of enuresis to be made, the behavior cannot be attributable to the physiological effects of a substance or another medical condition. Answer D: There may be precipitating factors (e.g., psychosocial stress) that account for the development of enuresis whether the disorder is primary or secondary.

Question ID #4442: Which of the following characteristics is LEAST relevant to consider when assessing a client's ego functioning? Select one: A. Gender B. Age C. Impulse control D. Culture

The correct answer is A.The question is looking for which characteristic is LEAST relevant in assessing a client's ego functioning, which is gender. While there are some gender-based differences in ego functions, differences based on age and culture are more significant. Ego functions include reality-testing capacity (e.g., judgment, accurate sense of reality), self-control and self-regulation (e.g., impulse control, frustration tolerance), capacity for interpersonal relationships (object relations), cognitive functioning (e.g., intelligence level, logic, memory), integrative functioning (e.g., the ability to adaptively integrate conflicting attitudes, behaviors, values, affects, etc.), and defense mechanisms. Answer B: Age is relevant to assessing ego functioning. Answer C: Impulse control is an ego function. Answer D: Culture is relevant to assessing ego functioning.

Question ID #4455: The client is a middle-aged man with a wife and two kids. He seems very anxious in the first interview and reports that he just lost his job. What environmental factors should be emphasized at intake? Select one: A. Socioeconomic and interpersonal relationships B. Job skills and interpersonal relationships C. Social skills and marketability D. Cultural background and support network

The correct answer is A.These areas relate best to the presenting problem and concrete needs the client may have at this time. Assessing these areas would provide information about the client's financial situation (now that he has lost his job) and support network. Answer B: This answer does not mention assessing the family's financial needs. The social worker needs to determine whether the client needs assistance to meet his family's basic needs at this time. Answer C: This answer does not mention assessing the family's financial needs. Answer D: The idea of assessing cultural factors might have been tempting, but the case does not provide the race, ethnicity, or culture of the client. A more important concern, however, is to assess the client's financial situation so that you can determine whether he needs assistance to meet his family's basic needs at this time.

Question ID #4501: The parents of a 12-month-old boy report that he has no vocabulary of his own. They add that he can understand some of what other people say. What should the social worker advise the parents to do about this? Select one: A. Not worry because it reflects normal development B. Consult with a speech pathologist C. Speak to the child's pediatrician D. Have the child screened for autism spectrum disorder

The correct answer is A.These parents should relax. While many children begin to talk around their first birthday, first words may be spoken at any time from 10 to 15 months of age. Any age within this range reflects normal development. Answer B: There is no need to consult with a speech pathologist, as the boy's development is within the normal range. Answer C: There is no need to consult with the child's pediatrician, as the boy's development is within the normal range. Answer D: The boy's development is within the normal range, and his lack of vocabulary is not an indicator of autism spectrum disorder.

Question ID #4515: A conflict between trust and mistrust is MOST likely to be apparent in which of the following? Select one: A. A 6-month-old who is fearful of a new babysitter B. A 5-year-old who doesn't want to go to kindergarten C. An 11-year-old who is afraid of the school bully D. An adolescent who is afraid of dating

The correct answer is A.Though it doesn't say so directly, this question requires you to think about Erikson's stages of psychosocial development-i.e., a conflict between trust and mistrust are the key words in the question. You needed to remember that each of Erikson's stages is associated with a particular conflict, and, perhaps more importantly, the age span when each of these conflicts occurs. According to Erikson, a 6-month-old is struggling with the conflict of trust vs. mistrust (birth to 12 months of age). Answer B: Erikson would say that a 5-year-old is struggling with the conflict of initiative vs. guilt (age 3 to 6 years). Answer C: Erikson would say that an 11-year-old is in the latency stage and struggling with the conflict of industry vs. inferiority (age 6 to 12 years). Answer D: According the Erikson, the conflict of ego identity vs. role confusion occurs during adolescence.

Question ID #4477: Which of the following alcohol-related diseases is the MOST serious or life-threatening? Select one: A. Wernicke-Korsakoff syndrome B. Cirrhosis C. Hepatitis D. Peptic ulcer

The correct answer is A.Wernicke-Korsakoff syndrome is a life-threatening alcohol-related disorder resulting in persistent memory loss and caused by malnutrition and thiamine deficiency. The disease consists of two stages: Wernicke's encephalopathy develops suddenly and produces abnormal eye movements, ataxia, slowness, and confusion. Sufferers also have signs of neuropathy, such as loss of sensation, pins and needles sensations, and/or impaired reflexes. The level of consciousness progressively falls; without treatment, this may lead to coma and death. Korsakoff's psychosis may follow Wernicke's encephalopathy if treatment is not initiated early enough. Symptoms include severe amnesia, apathy, and disorientation, with recent memory affected more than distant memory. Confabulation (invention of facts or stories) may occur in order to compensate for memory gaps. Answer B: Cirrhosis is most often the result of chronic alcohol use and is a chronic, degenerative disease of the liver. Although it can lead to death, cirrhosis progresses over a long period of time-usually years. Answer C: Hepatitis generally refers to an inflammatory condition of the liver caused by bacterial or viral infection, parasitic infestation, alcohol, drugs, toxins, or transfusion of incompatible blood. When severe, hepatitis may lead to cirrhosis and chronic liver dysfunction. A specific form of hepatitis known as alcoholic hepatitis is an acute toxic liver injury associated with excess alcohol consumption. Certain medications may be used to treat this condition, and long-term survival is improved with abstinence or decreased alcohol consumption. Answer D: A peptic ulcer may be a medical consequence of chronic alcohol use, but it is not the most serious alcohol-related disease.

Question ID #4445: A social worker conducting an interview with a patient who was recently admitted to a hospital notices that the patient takes an unusually long time to answer questions because he spends a lot of time providing minute details and making parenthetical comments. However, the patient doesn't lose track of the point he is trying to make, and he usually ends up answering the questions. The patient's speech pattern is BEST described by which of the following terms? Select one: A. Loosening of associations B. Circumstantiality C. Confabulation D. Flight of ideas

The correct answer is B.A key feature of this patient's speech is that he doesn't lose the original point of his communication. His speech pattern illustrates circumstantiality: his speech wanders, but he continues to be aware of his original point. Answer A: Loose associations involve abrupt shifts from one fragmented thought to another, with little, if any, logical connection between the thoughts, and with loss of the original point of the communication. Answer C: Confabulation involves the fabrication of experiences or situations in order to fill in and cover up gaps in memory. Answer D: Flight of ideas is verbal presentation in which a person's responses seem to take off based on a particular word or thought, unrelated to any logical progression or the original point of the communication.

Question ID #4481: An African American man, age 30, comes to see a White social worker to discuss ways of dealing with stress. During the first interview, the client is aloof and reluctant to talk to the social worker. The research suggests that it would be MOST appropriate for the social worker to interpret the client's behavior as reflecting which of the following? Select one: A. A generally negative view of therapy B. An active effort to evaluate the social worker C. Resistance D. Deference to or respect for an authority figure

The correct answer is B.Because of experiences with racism, prejudice, and discrimination, African American clients may mistrust white therapists. Additionally, African American males may consider participation in therapy to be an admission of weakness or a sign of unmanliness and therefore be particularly reluctant to share personal information (Lee, 1990). Sue and Sue (1999) have suggested that aloofness and non-responsiveness on the part of an African American client may be a protective mechanism-i.e., the client may believe that sharing personal information will make him vulnerable to racism. Rather than reflecting resistance, this behavior may be an active way of evaluating the therapist. It is recommended that therapists respond to this behavior in a straightforward way because this can facilitate the development of trust. Answer A: If the client had a generally negative view of therapy, they probably wouldn't have come in asking for help. Answer C: Resistance refers to clients' opposition to therapeutic interventions that they fail to understand or accept, or to the resistance to delve into scary, painful, shameful, etc. feelings. It is too soon for resistance to arise in this instance. Answer D: This might be more likely in an Asian client, where deference and respect for authority figures is part of the culture.

Question ID #4448: A social worker begins working in individual therapy with a client who has difficulty sustaining long-term relationships. The client reports that he drives people away because he has a short fuse and he wishes he could control that better. The client never harms others, but he sometimes loses his temper and says things that he regrets later. The social worker uses a behavioral approach with this client and, during assessment, performs a functional analysis of the target behavior. What is the PRIMARY purpose of performing a functional analysis? Select one: A. To provide data that will allow the social worker to determine the effects of intervention B. To determine the stimuli that typically precede and follow the target behavior C. To determine the frequency, magnitude, and duration of the target behavior D. To identify the determinants of the behavior that the client is unaware of

The correct answer is B.Functional analysis is a key part of behavioral assessment used to evaluate the target behavior itself and the stimuli that precede it (antecedents) and the consequences that follow and maintain it. The common term for these antecedents and consequences is contingencies - i.e., a therapist using behavioral therapy is interested in determining the stimuli and situations upon which the target behavior is contingent, and a goal of therapy is then to manipulate these contingencies in order to change the behaviors associated with them. The functional analysis will allow you and the client to determine how the target behavior can be predicted and controlled-for example, it can show what changes in antecedent stimuli would result in a change of the behavior. Answer A: The results of a functional analysis are useful both for identifying an appropriate intervention and monitoring its effects. However, B describes the primary purpose of functional analysis. Answer C: This answer describes a general assessment of the problem behavior. Answer D: This answer focuses on unconscious triggers, not the actual operational components of the behavior (for example, a leads to b, which causes c).

Question ID #4517: In crisis theory, the initial shock that disrupts a person's equilibrium and initiates a series of reactions that may culminate in a crisis is called: Select one: A. the precipitating factor. B. the hazardous event. C. a vulnerability. D. an immobilizing event.

The correct answer is B.In crisis theory, the hazardous event is an initial shock that disrupts a person's equilibrium and initiates a series of reactions that may culminate in a crisis. This state is marked by an increase in anxiety that the person attempts to relieve by using customary coping strategies. If these are unsuccessful, the person's tension continues to rise and, eventually, they are unable to function effectively. Answer A: The precipitating factor is the final stressful event in a series of events that moves a person from a state of vulnerability into crisis. The precipitating factor often is a minor event, but it can assume catastrophic proportions in the context of other stressful events and the person's inability to use their usual problem-solving strategies. Answer C: The vulnerable state follows a hazardous event and refers to the person's subjective response to stressful events in their life. Answer D: Immobilization (inability to function) may result from a failure of coping mechanisms after a hazardous event.

Question ID #4514: The client is a 20-year-old immigrant from Turkey who came to the U.S. with his family when he was 16. The client says he's becoming more like his American friends and is uneasy about that. He wants to fit in but doesn't want to lose his own customs and values. He acts one way when he's with his family and another way when he's with his friends. He asks the social worker what she thinks about that. Based on her familiarity with contemporary models of acculturation, the social worker is MOST likely to tell the client that efforts to function well within both one's culture of origin and the mainstream culture: Select one: A. may produce overwhelming levels of stress. B. may be associated with better adaptation. C. often produce confusion and identity crises. D. lead to social isolation.

The correct answer is B.Some experts have suggested that the best possible outcome of acculturation is the ability to function well in both one's culture of origin and the dominant (mainstream) culture. In order to become bi-culturally competent, immigrants need knowledge of the new cultures, beliefs, and values; a positive attitude toward both cultures; the belief that they can live happily and successfully in both groups without compromising their sense of cultural identity; supportive and reliable social networks in both groups; a broad range of culturally and situationally appropriate behaviors and roles; and communication competency. Answer A: Trying to either stay completely true to one's culture of origin or completely abandon it for the new, dominant culture may produce overwhelming levels of stress. Answer C: There may be periods of confusion and identity issues, but ultimately, being able to be bi-culturally competent leads to a better adaptation overall. Answer D: Being able to function bi-culturally should broaden the client's social connections, not isolate him.

Question ID #4494: The identified patient is the symptom bearer in a family or the official patient as identified by the family. From a systems point of view, the identified patient's symptoms serve as: Select one: A. an unbalancing mechanism. B. a negative feedback mechanism. C. a positive feedback mechanism. D. a catalyst for second order change.

The correct answer is B.The identified patient's (IP's) symptoms signal the family imbalance or pain and serve to maintain family homeostasis. Thus, improvement in the IP's symptoms usually causes the family to encourage the redevelopment of their symptoms and/or the development of symptoms in another family member. The family's homeostasis is maintained by such negative feedback that recalibrates the system and restores a comfortable balance. From a systems point of view, then, the identified patient's symptoms serve as a negative feedback mechanism. Answer A: Unbalancing is a strategy in structural therapy whereby the therapist disrupts the relationships within the family (for example, by briefly taking sides with different members of the family) so as to encourage new interactional patterns. Answer C: Positive feedback loops in therapy result in change from the homeostasis. Answer D: First order change is a change in behavior; second order change involves change at a deeper level.

Question ID #4509: The parents of a preschooler (age 3) request an evaluation of their child because he seems like a "loner." They worry that he may have autism spectrum disorder because he plays by himself in day-care rather than interacting with the other children. When questioned by the social worker, the parents report no other significant concerns about the boy. What should the social worker do FIRST? Select one: A. Observe the boy while he plays with toys in her office B. Talk to the parents about normal play behavior at this age C. Screen for developmental delays and refer the boy to a pediatrician D. Arrange to observe the boy at home and in other environments

The correct answer is B.This is the best answer because the boy's play behavior is typical for a 3-year-old (and because these parents report no other significant concerns about the boy). Solitary play, in which a child plays alone (he is engaged in a task, but not with other children), is typical of 2- to 3-year-olds. Answer A: Since the parents have no other significant concerns about their son, there is no need to proceed with an assessment, since his behavior is typical for his age. Answer C: Since the boy's behavior is typical for his age, this is unnecessary. Answer D: Since the boy's behavior is typical for his age and the parents have no other significant concerns about their son, there is no need to proceed with an assessment.

Question ID #4498: Early onset persistent bilateral otitis media with effusion has been linked to which of the following? Select one: A. Stuttering B. Intellectual disability C. Specific learning disorder D. Autism spectrum disorder

The correct answer is C.Bilateral otitis media with effusion is a severe form of middle ear infection involving inflammation of the left and right middle ear with fluid leakage. Middle ear infections in early childhood, especially severe infections resulting in hearing loss, have been associated with attention deficits and the development of specific learning disorder later in childhood. Answer A: Studies of language-disordered children with and without a history of recurrent otitis media have revealed no differences in severity or pattern of language disorder. Answer B: Ear infections have not been linked to intellectual disabilities. Causes for intellectual disability include chromosomal abnormalities, metabolic problems, environmental and/or nutritional issues, toxic exposure, trauma, etc. Answer D: The exact cause of autism spectrum disorders is unknown, although genetic mutations, viral infections during pregnancy, exposure to toxins, etc. are suspe

Question ID #4469: Which of the following DSM-IV-TR diagnostic criteria for PTSD has been removed in the DSM-5? Select one: A. Intrusion symptoms B. Alterations in arousal and reactivity C. A response to the trauma of fear, helplessness, or horror D. Avoidance of stimuli associated with the trauma

The correct answer is C.One of the DSM-IV-TR's requirements for PTSD is intense fear, helplessness, or terror in response to the traumatic event. This requirement was eliminated in the DSM-5. Answer A: The presence of intrusion symptoms is included as a criterion for a DSM-5 diagnosis of PTSD. Answer B: Alterations in arousal and reactivity are criteria for a DSM-5 diagnosis of PTSD. Answer D: Avoidance of stimuli associated with the traumatic event is a criterion for a DSM-5 diagnosis of PTSD.

Question ID #4487: In a family in which a father has molested his daughter, desired change is MOST likely to occur when which of the following happens? Select one: A. The mother protects the daughter B. The mother acknowledges the abuse C. The daughter acknowledges the abuse D. The father acknowledges the abuse

The correct answer is C.Psychological treatment of child abuse is typically most effective when intervention begins with individual therapy for the child and gradually broadens to include all family members. Important goals of psychotherapy with the child are to help her develop adaptive ways of coping with the feelings associated with the abuse and reformulate the meaning of her abuse experiences (e.g., modify her attribution of responsibility for the abuse). For many children, however, the first stage of treatment must focus on helping them acknowledge-whether directly or indirectly-that abuse happened to them and identify and express the feelings and cognitions (e.g., self-blame) associated with it. Answer A: The mother's efforts to protect her child and willingness to acknowledge what happened can help mitigate the long-term negative effects of the abuse for the girl, but these events are not as closely associated with change in the family system. Answer B: The mother's acknowledgement of the abuse can help mitigate the long-term negative effects of the abuse for the girl, but it is not as critical to change in the family system as the daughter's acknowledgement of the abuse. Answer D: The father's acknowledgement the abuse is critical but doesn't necessarily mean that he will change his behavior or acknowledge its effects on his child or family. Sexual abuse of children is considered a treatable, but not curable, behavioral problem. The primary goal of treatment is to minimize the likelihood that the person will re-offend, and this is best done by modifying emotional, cognitive, psychological, behavioral, and environmental factors that support the desire, capacity, and opportunity to offend. Cognitive-behavioral therapies, including relapse prevention, tend to be most effective for reducing recidivism rates.

Question ID #4463: The DSM-IV-TR diagnoses of substance abuse and substance dependence are combined in the DSM-5 into the single diagnosis of substance use disorder. Which of the following was included as a symptom of substance abuse or substance dependence but is NOT included as a symptom of substance use disorder? Select one: A. Persistent desire or unsuccessful efforts to control substance use B. Recurrent use of the substance in situations in which it is physically hazardous C. Recurrent substance-related legal problems D. A strong desire or urge (craving) to use the substance

The correct answer is C.Recurrent substance-related legal problems is a possible symptom of substance abuse in the DSM-IV-TR but is not included as a symptom of substance use disorder in DSM-5. Answer A: A persistent desire or unsuccessful efforts to control substance use is one of the symptoms of substance use disorder included in the DSM-5 and of substance dependence in the DSM-IV-TR. Answer B: Recurrent use of the substance in situations in which it is physically hazardous is a symptom of substance use disorder in DSM-5 and of substance abuse in DSM-IV-TR. Answer D: A craving for the substance was not included as a symptom in the DSM-IV-TR for substance abuse or dependence, but is included as a symptom of substance use disorder in DSM-5.

Question ID #4488: A social worker is working in individual therapy with a client whose culture differs from her own. To facilitate her ability to work successfully with this client, the social worker attends to certain characteristics of his communication, how they differ from hers, and how this may affect their interactions. When attending to "paralanguage," what is the social worker concerned with? Select one: A. Personal and interpersonal space B. Facial expressions, gestures, eye contact, and other body movements C. Loudness of voice, silence, rate of speech, and other vocal cues D. Culturally shared meanings for certain words and phrases

The correct answer is C.Sue and Sue (2003) describe several aspects of communication that are influenced by culture and may affect interactions between people from different cultural backgrounds. Paralanguage refers to the vocal cues (other than language itself) that are used to communicate meaning. Answer A: The use of personal and interpersonal space is referred to as proxemics. Answer B: The use of body movements as a form of communication is called kinesics. Answer D: Paralanguage does not refer to culturally shared meanings for words and phrases.

Question ID #4454: A social worker is meeting for the first time with a family that includes a mother, father, and 11-year-old son. The mother was diagnosed with cancer a few months ago, and the doctors have said that her prognosis is fair to poor. The parents report that they are concerned about their son, who has been acting out at home and in school since learning that his mother is sick. He has also been isolating himself. The social worker observes that the boy is subdued in the interview and doesn't make eye contact with either of his parents. What should the social worker do FIRST? Select one: A. Determine the family's support needs, including what needs to be done to facilitate their access to adequate medical treatments for the mother B. Gather a history of the mother's medical condition and seek permission to speak with her physician immediately C. Evaluate how the family as a whole is coping with the mother's diagnosis D. Discuss the boy's behavior in more depth with the parents, including its nature and frequency, and seek permission to confer with the boy's teacher

The correct answer is C.The entire family is facing a difficult stressor, and the question implies that the boy's problematic behavior developed in response to this stressor. To get a better understanding of the parents' concerns and the boy's problems, the social worker should explore how the family as a whole is coping with the mother's illness: Are family members able and willing to talk about it openly? Does the family tolerate expressions of sadness, fear, etc.? Answer A: The family needs support; however, the presenting problem concerns the boy's behavior, not lack of access to adequate medical care. Answer B: It will be a good idea to learn more about the mother's medical condition and confer with her physician, but this is not the social worker's priority. C is a more important initial step since the parents have described concerns about their son's behavior. Answer D: The social worker will want to get details about the boy's behavior and confer with his teacher at some point, but given the presenting problem and its probable cause (the stressor the family is undergoing), it's more important initially to assess the family as a whole, particularly how they've been handling and coping with this stressor.

Question ID #4506: A 20-year-old man is diagnosed with schizophrenia and is hospitalized. After a month, he is considered to be sufficiently stabilized on medication to return home to his parents' house. According to the concept of homeostasis, which of the following is LEAST likely to happen when the man returns to his family? Select one: A. His parents will separate. B. A younger child in the family will develop behavioral symptoms. C. Family rules will change to allow the family to support the man. D. A previously functional family member will develop psychiatric symptoms.

The correct answer is C.The question seeks what is LEAST likely to happen. Homeostasis is a self-regulating process that maintains equilibrium in an organism or system-i.e., it is the tendency of a system to react toward restoring the status quo when change occurs. The concept of homeostasis would predict the opposite of what Answer C says: rather than changing its rules to support the recovered family member, the family would be expected to behave in ways that restore the family to its familiar balance-i.e., a family that includes a sick member. Answer A: According to the concept of homeostasis, this may happen because the 20-year-old's recovery will upset the family's familiar balance. Answer B: This is predicted by the concept of homeostasis: the family is accustomed to having a sick member. Thus, to maintain balance, someone in the family will need to be the symptom bearer-i.e., to signal or absorb the family's pain. Answer D: This is predicted by the concept of homeostasis, as it would serve to maintain the homeostatic condition.

Question ID #4441: A 26-year-old client complains of low self-esteem and feelings of shame about behaviors he engaged in while he was a student in college. The client appears nervous in the interview, but he is able to carry on a conversation and his affect is appropriate. What does appropriate affect refer to? Select one: A. The ability to express a full range of emotions B. The ability to manage strong feelings that would otherwise interfere with adaptive functioning C. An emotional tone that matches the idea, thought, or topic that one is describing D. A willingness to talk about feelings

The correct answer is C.This is a concise description of appropriate affect. Compared to mood, affect is more reactive and variable (affect is an emotional state of relatively short duration). Affect is considered to be appropriate when an individual is in touch with his emotions and can express them as he feels them in response to specific emotional or situational stimuli (e.g., he cries when talking about something very sad). Answer A: This refers to range of affect. Answer B: This refers to emotional regulation. Answer D: This refers to the client's degree of openness.

Question ID #4507: A family has been referred by their pediatrician because the 9-month-old daughter is underweight and doesn't eat adequately. The pediatrician has ruled out a medical condition that could account for the problem, and the child has been diagnosed with nonorganic failure to thrive. Given this diagnosis, which of the following is the social worker LEAST likely to find when he evaluates this family? Select one: A. The mother experienced deprivation in childhood. B. There are parent-child interaction problems. C. There are unsanitary living conditions and high levels of lead in the home. D. There are high levels of stress and parental depression.

The correct answer is C.This question is about factors associated with nonorganic failure to thrive. Lead poisoning has not been associated with failure to thrive; instead, it may affect a child's cognitive abilities. In addition, with nonorganic failure to thrive, the symptoms are not attributable to a medical cause. Answer A: Many mothers of failure-to-thrive infants were deprived in their own childhood, which may interfere with their ability to adequately meet their baby's emotional, feeding, and other needs. Answer B: Some babies are born with a temperament that makes them difficult to feed. For example, some babies are irritable and difficult to comfort during feeding, and parent-child interaction problems may play a role in or intensify the feeding problem if the parents don't know how to respond to their child's needs or if they respond to her refusal to eat as though it were a sign of rejection or an act of aggression. In other cases, parents who are overly controlling get into food battles with their baby. Answer D: Among the family factors that have been associated with failure to thrive are high levels of stress and depression in the household.

Question ID #4500: Researchers interested in the relationship between basic temperament and personality later in life have found that: Select one: A. temperament and personality are both products of the social environment. B. temperament is inherited and will change only if social-environmental conditions are extreme. C. the impact of temperament on personality depends on the fit between temperament and characteristics of the social environment. D. temperament in early childhood is not predictive of later personality development.

The correct answer is C.This question requires familiarity with the goodness-of-fit model (Thomas & Chess, 1977). Thomas and Chess proposed that most babies can be categorized as having either an easy, difficult, or slow-to-warm-up temperament and that many children categorized as difficult or easy at age 3 were rated, respectively, as poorly- or well-adjusted as young adults. However, the relationship between early temperament and later adjustment was not perfect, and, based on this finding, Thomas and Chess developed a goodness-of-fit model that predicts that it is the degree of match between parents' behaviors and the child's temperament that contributes to the child's outcomes. Answer A: Temperament seems to be affected by heredity and is, to some degree, apparent at birth and predictive of later personality and adjustment. Answer B: While temperament seems to be somewhat inherent at birth, it is still malleable to environmental and social influences. Answer D: Temperament seems to be affected by heredity and is, to some degree, apparent at birth and predictive of later personality and adjustment.

Question ID #4503: A social worker is interviewing a 15-year-old boy who has been referred by the juvenile court following an arrest for vandalism. The client often skips school and says he has no plans for the future other than having fun. He doesn't think anyone should be able to tell him what to do. Based on this information and the client's age, which of the following is LEAST likely to be true? Select one: A. The client is in the midst of an identity crisis. B. The client is egocentric. C. The client thinks his own experiences are unique. D. The client is acutely aware of his own mortality.

The correct answer is D.Awareness of one's own mortality is least likely to be true about this client (or any adolescent). Adolescence is marked by a renewed egocentrism (Answer B). According to Elkind (1967), egocentrism in adolescence is manifested in two ways: (a) imaginary audience, wherein adolescents often feel as though others are watching or paying attention to them (i.e., as though they are on stage), which accounts for their extreme self-consciousness; (b) personal fable, wherein adolescents believe deeply in the uniqueness of their own experiences, which produces a sense of immortality and invulnerability to harm (which is the opposite of what Answer D says). Answer A: Erikson, who introduced the term "identity crisis," considered the primary developmental task of adolescence to be the achievement of a coherent identity. Erikson's view was expanded by Marcia (1987), who distinguished between four identity statuses that reflect the degree to which an adolescent is experiencing or has experienced an identity crisis and is committed to an identity. Some adolescents have resolved the identity crisis by evaluating alternatives and committing to an identity. Many others, however, have not. This client's behavior suggests that his identity status is likely to be identity moratorium (rather than identity achieved)-with this status, the adolescent experiences an identity crisis and actively explores alternative identities. During this period, an adolescent exhibits a high degree of confusion, discontent, and rebelliousness. Answer B: Adolescence is marked by egocentrism. Answer C: This is true of most adolescents.

Question ID #4496: According to Sigmund Freud, obsessive-compulsive behavior is the result of fixation at what stage of psychosexual development? Select one: A. Oral B. Genital C. Phallic D. Anal Feedback

The correct answer is D.Freud's theory of psychosexual development explains how the id's instincts interact with childhood experiences to produce adult personality. According to Freud, the id's libido (sexual energy) centers on a different part of the body during each stage of development, and personality results from the ways in which conflicts at each stage are resolved. Failure to resolve a conflict at any stage stems from either inadequate or excessive gratification of the ids needs, and can result in fixation at that stage. Fixation at the anal stage (1-3 years) produces anal retentiveness (obsessive-compulsive behavior, stinginess, selfishness, orderliness, cleanliness) or anal expulsiveness (cruelty, destructiveness, messiness, disorder). Answer A: A fixation at the oral stage of development (0-18 months) may result in a desire for constant oral stimulation such as through eating, smoking, alcoholism, nail-biting, or thumb-sucking. Answer B: A fixation at the genital stage of development (puberty-death) would result in a person remaining overly focused on sexuality to the detriment of other interests. Answer C: A fixation in the phallic stage (3-6 years) would mean, for young boys, an obsession with their own penis. For young girls, this would be a fixation on the fact that they don't have a penis, otherwise referred to as penis envy.

Question ID #4451: A social worker's client is angry at his neighbor for cutting down a large tree that afforded the client privacy in his backyard. The client is agitated and tense as he describes this event and says that he and the neighbor had a heated argument about it the day before, in which the neighbor called him a loser. The client has a history of poor impulse control, including stealing and excessive alcohol use. He has been arrested on several occasions for bar fights that he initiated and has spent time in jail. Which of the following factors present in this case is the BEST predictor of whether this client is likely to be violent toward his neighbor? Select one: A. The recent provocation B. The client's poor impulse control C. The signs of tension and agitation D. The client's prior violent behavior

The correct answer is D.The best predictor of future violent behavior is one or more previous acts of violence. Answer A: Although this is a contributing factor to the risk profile in this case, the best predictor of future violent behavior is a history of previous violence. Answer B: Although the client's poor impulse control is a contributing factor to the risk profile in this case, the best predictor of future violent behavior is one or more previous acts of violence. Answer C: These are important indicators, but the best predictor of future violent behavior is a history of previous violence.

Question ID #4505: A social worker is working in family therapy with a family of five (Mom, Dad, a 12-year-old boy, a 3-year-old boy, and an infant girl) in which the toddler son has been acting out since the birth of his sister three months ago. Mom is convinced that her toddler son is jealous of his sister. The social worker, however, is concerned with how the whole family has reorganized itself following the girl's birth and asks the clients about this. In general systems theory, this concept that any change in one part of a family system (or other system) will cause change in other parts of the system and eventually the whole system is known as: Select one: A. accommodation. B. multifinality. C. equifinality. D. wholeness.

The correct answer is D.This question is referencing the systems theory concept of wholeness, which maintains that combining units, components, or elements produces an entity that is greater than the sums of its parts. Therefore, a system cannot be adequately understood or fully explained if it is broken down into its component parts, and no element within a system can ever be understood in isolation because it never functions independently. Because of a system's wholeness, the movement of each part of the system influences the whole system and is explained, in part, by movement in related parts of the system. Answer A: Although this sounds correct (a layperson might think the whole system accommodates to change in one part of the system), an LCSW should know that it isn't. Answer B: The systems theory principle of multifinality (many ends) refers to the fact that one cause (one action) may produce many different effects or outcomes. Answer C: The systems theory principle of equifinality (same end) refers to the fact that a single effect or outcome may result from several different causes.

Question ID #4499: Memory loss among patients suffering from Alzheimer's disease is believed to be caused by a deterioration of neurons that secrete: Select one: A. GABA. B. serotonin. C. dopamine. D. acetylcholine.

The correct answer is D.You may have been aware that acetylcholine is associated with motor functions. It has also been linked to memory processes. Alzheimer's disease is associated with deterioration of ACh-secreting neurons in the brain. Answer A: GABA has been linked to sleep, eating, seizure, and anxiety disorders. Answer B: Elevated levels of serotonin contribute to schizophrenia and autism spectrum disorder. Low levels of serotonin play a role in depression, suicide, PTSD, obsessive-compulsive disorder, and aggression. Answer C: Low levels of dopamine are associated with some forms of depression. Excessive activity at dopamine synapses has been linked to schizophrenia and Tourette syndrome.